Gift Aid Declaration

Name of Charity:
Details of Donor: Title _______ Forename____________________ Surname_________________________ Home Address _____________________________________________________________ _____________________________________________________________ Postcode _________________________

I want the charity to treat * The enclosed donation of _________ as a Gift Aid donation * The enclosed donation(s) of ________ which I made on (date) ___ / ___ / ___ as (a) Gift Aid donation(s) * Please delete as appropriate You must pay an amount of Income and/or Capital Gains Tax at least equal to the tax that the charity reclaims on your donations to the appropriate tax year. (i.e. 25p for each £1 you give on or after 6 April 2008)

Signature _______________ Or Company’s stamp



Notes 1. You can cancel this Declaration at any time by notifying the charity. 2. If in the future your circumstances change and you no longer pay tax on your income and capital gains equal to the tax that the charity reclaims, you can cancel your declaration. 3. If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return. 4. Please notify the charity if you change your name or address. 5. Please refer to the HMRCwebsite ( for any further information.

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